Researcher: ND Page 1 4/5/22
OLR Bill Analysis
HB 5275
AN ACT PROHIBITING CERTAIN HEALTH CARRIERS FROM
REQUIRING STEP THERAPY FOR PRESCRIPTION DRUGS USED
TO TREAT MENTAL OR BEHAVIORAL HEALTH CONDITIONS.
SUMMARY
This bill prohibits individual and group health insurance policies
from requiring the use of step therapy for drugs prescribed to treat
covered individuals with mental or behavioral health conditions, so
long as the drugs comply with approved U.S. Federal Drug
Administration indications. (Step therapy establishes a sequence for
prescribing drugs for specific medical conditions that generally requires
patients to try less expensive drugs before higher cost drugs.)
The bill applies to individual and group health insurance policies that
provide prescription drug coverage and are delivered, issued, renewed,
amended, or continued by an insurer, hospital or medical service
corporation, HMO, or other entity.
EFFECTIVE DATE: January 1, 2023
BACKGROUND
Related Bill
SB 331, favorably reported by the Public Health Committee, contains
similar provisions prohibiting insurers from requiring the use of step
therapy for mental or behavioral health medications.
COMMITTEE ACTION
Public Health Committee
Joint Favorable
Yea 29 Nay 2 (03/18/2022)